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Mild hypertension doesn’t always need treatment, concerns about the doc-in-the-box, and who’s your doctor, really?: RightCare Weekly

September 18, 2014

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

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Features: 

Alexandra Sifferlin writes for Time about a new paper by Lown Institute President Vikas Saini, MD, and others, which argues that treating most patients with slightly elevated blood pressure is likely to do more harm than good. The paper is part of a series in The BMJ on overdiagnosis. In it, the authors argue that treatment recommendations for mild hypertension have been based on evidence of benefits for patients with more severe hypertension; the benefits of treating mild hypertension remain speculative, and the evidence is insufficient to warrant widespread drug treatment of that very common condition.

 

In her op-ed in the Providence Journal, Lown Institute Senior Vice President Shannon Brownlee, cautions against emerging retail clinics, like MinuteClinic at CVS, because they view patients solely as customers who will advance their bottom line. Unlike primary care physicians, retail clinics have no interest in getting to know the patient, his or her individual lives, needs and circumstances. And there’s another bad outcome with retail clinics: They undermine the financial stability of primary care physicians, as they siphon off easy cases and easy revenue.

 

Boston Globe piece by Deborah Kotz last week profiles Leana Wen, MD, who advocates for physicians to be more transparent with their patients. She suggests that patients ought to know if their doctors are paid fee-for-service, their personal views on topics like abortion, and whether they have financial interests linked to treatments, all of which, she believes, factor into how they care for patients. Wen, who is a member of the Lown Institute’s advisory council, is joined by RightCare Alliance members Tanner Caverly, MD, Zack Berger, MD, Josh Kosowsky, MD, and Aaron Stupple, MD in her call for transparency. Physicians’ profiles vary, from focusing on philosophies relating to curbing overuse of healthcare resources, end of life issues, even religious beliefs and political affiliations. Wen cites her mother’s journey through cancer treatment, and discovering that the treating oncologist was also a spokesperson for the pharmaceutical company that made the chemotherapy regimen prescribed.

 

Announcement: If you’re enjoying what you read in RightCare Weekly, we hope you’ll get more involved in the RightCare Alliance! Come to our first regional conference, October 11 in Denver, CO, or email organize@lowninstitute.org for information on hosting your own event!

 

Headlines:

End-of-life care

  1. Straight Talk About Palliative Care: What Everyone Should Know – Barbara Sadick, Wall Street Journal
  2. Can We Have a Fact-Based Conversation About End-of-Life Planning? – Brendan Nyhan, The Upshot
  3. Use of Medications of Questionable Benefit in Advanced Dementia – Jennifer Tjia, et al., JAMA Internal Medicine
  4. I QUIT! Will the law force us to provide futile, harmful care? – Jessica Otte, MD, Less Is More Medicine blog
  5. What’s Behind the Criticism of Hospice? Is It Fair? – Howard Gleckman, Forbes

 

Chronic disease care

  1. Intensive Interventions Reduce Readmissions Globally – Marcia Frellick, Medscape
  2. Depression more common for cancer patients, but rarely treated – Kathryn Doyle, Reuters
  3. A third of family caregivers spend over $10K a year – Nancy Hellmich, USA Today
  4. You’re Being Observed In The Hospital? Patients With Private Insurance Better Off Than Seniors – Susan Jaffe, Kaiser Health News/Washington Post

 

Patient safety

  1. Door-to-balloon time – Aaron Segal, MD and Richard Young, MD, RightCare Blog
  2. Drug-testing rules broken by Canadian researchers – Jesse McLean and David Bruser, Toronto Star
  3. Patients Vulnerable When Cash-Strapped Scientists Cut Corners – Richard Harris, NPR

 

Pharma

  1. New York Files an Antitrust Suit Against the Maker of an Alzheimer’s Drug – Andrew Pollack, New York Times
  2. Drug pricing: A new prescription – Sylvia Pag­an Westphal, Boston Globe

 

Overdiagnosis

  1. Some Cancer Experts See ‘Overdiagnosis,’ Question Emphasis on Early Detection – Melinda Beck, Wall Street Journal
  2. Mobile Health Screenings Come Under Scrutiny – Tinker Ready, HealthLeaders Media

 

Tech in medicine

  1. 5 Things Preventing Technology Adoption In Health Care – Robert Pearl, Forbes
  2. Exclusive: Two Apple medical trials shed light on how HealthKit will work – Christina Farr, Reuters

 

Medical evidence

  1. Let’s Ban the Phrase ‘Studies Show’ From Medical Lingo – Brian Secemsky, MD, Huffington Post
  2. Re-analyses of clinical trial results rare, but necessary, say Stanford researchers – Krista Conger, Stanford Medicine’s Scope blog

 

Defensive medicine?

  1. The cost of defensive medicine – Aaron Carroll, AcademyHealth Blog
  2. Doctors’ Dilemma: Lower Costs, Please Patients, or Avoid Lawsuits? – Leigh Page, MS, Medscape

 

Patient decision making

  1. Be wary of doctor-rating sites – Kevin Pho, USA Today
  2. Radiologists Push for Medical Reports Patients Can Understand – Laura Landro, Wall Street Journal
  3. Medical Calculators Use Big Data to Help Patients Make Choices – Laura Landro, Wall Street Journal

 

The Right Care Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.

 

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